Secretary of Defense Lloyd J. Austin III’s failure to disclose his hospitalization for complications from prostate cancer at a particularly sensitive moment when we are fighting proxy wars in Ukraine and the Middle East has raised the expected political hackles as well as some fascinating philosophical questions.
What is our obligation to others as we face serious illness? Perhaps more important, what should our attitude be to serious illness — especially “The Emperor of All Maladies,” as oncologist Siddhartha Mukherjee, M.D., titled cancer in his challenging 2011 Pulitzer Prize-winning book and subsequent PBS documentary series, and the specter that is never far from it, death?
Given Austin’s vital job, but really in any job, you owe it to your boss and your profession to be frank about any health situation that requires you to be off the grid. This can go two ways. Your boss may be supportive and allow you the space and time to balance work and illness. Or you could have the kind of boss who pays legal lip service to supportiveness but then finds a way to get rid of you.
I had an editor who after a period of time ditched a graphics designer who had a benign brain tumor that nonetheless required convalescence. Heck, I even had a boss who found a plausibly deniable way to fire a pregnant co-worker, a totally actionable offense.
The point is you don’t want to appear vulnerable. This is why athletes sometimes minimize — or conversely sometimes maximize — injuries. You don’t want to give your opponent any ammunition, which includes the truth. And you have to imagine a four-star general like Austin didn’t get where he is by giving ground to an adversary — be it Hamas or hostile Republican Congressmen.
But there’s more to it than this. Work can be a burden when you’re seriously ill. It can also be a refuge and an escape if you can deal with it without associating it with your disease. Austin should’ve told President Joe Biden, of course. But should he have informed Congress or the press? Why?
When you inform people of your illness, there are several possible responses. The best you can hope for is someone who will be present to your suffering — someone who will listen, who will help when needed but who will also back off when required, too.
Unfortunately, there are other reactions that are less helpful. There are those who will hound you to death about your disease. Growing up, I had a bachelor neighbor who was at the front door every night to find out how my hospitalized uncle was. After a while, my aunt realized his genuine concern was tinged with the secret, erroneous notion that should my uncle die, my aunt would be an available widow. It was then left to me and my sisters, in Jane Austen fashion, to tell this neighbor, whom we’d nicknamed “How is he?” for his constant refrain, that my aunt was otherwise occupied.
There are those who would wallow in your situation as a way to congratulate themselves secretly on their own superior circumstances, also per Jane Austen’s on-target observations of human nature.
Then there are those who make any tragedy their own. They become the centerpiece of your drama. Thus only the first group, usually some in your innermost circle of friends and family but sometimes a professional in the health-care field, is attuned to what you are going through.
Does this mean public figures should never share their illnesses in the 24/7 digital age? Of course not. Jay Rutman, M..D., professor and chair of the Department of Urology at Penn State, told the “PBS NewsHour” that prostate cancer occurs at the same rate that breast cancer does in women: Prostate cancer is, however, nowhere near as famous. “…Women are excellent advocates for their health. You hear a lot about mammography, self-examination, getting checked, getting screened.”
Indeed, the triumph of breast cancer awareness and research is the triumph of marketing, beginning in the 1970s with Alexandra Penney, editor-in-chief of Self magazine, and Estée Lauder executive Evelyn Lauder, founders of The Breast Cancer Research Foundation, and breast cancer’s pink ribbon logo, after an idea introduced by breast cancer survivor Charlotte Haley,;and going on to first ladies Betty Ford and Nancy Reagan, who didn’t hide from their struggles with the disease; and Christina Applegate, Angelina Jolie, Joan Lunden NBC 4 New York anchor Pat Battle, Martina Navratilova, Chris Evert and Katie Couric, who are among those who either had breast cancer or had their breasts removed prophylactically because they are at risk for gynecologic cancers.
Their stories and the stories told at the annual fall fund-raising luncheon for Greenwich-based Breast Cancer Alliance at Westchester County Club in Harrison, New York, give sufferers hope, inspiration and courage. Had men such organizations for prostate cancer, that disease might be a different story. But men traditionally tend to recoil from anything that makes them appear vulnerable, and they’re not as good at collaborating as women are. But then women’s historical powerlessness has forced them to collaborate.
Still, sharing every little detail about your health challenge can overwhelm and repulse those who aren’t sick and don’t want to be reminded of illness, any more than some rich people want to be reminded of poverty.
Cancer is especially terrifying, becuase it underscores the notion that life may be a crapshoot. I once interviewed Dana Reeve, who met her husband Christopher Reeve’s catastrophic, paralyzing horse-riding accident with grace and courage, then died of lung cancer at 44. She never smoked, but as a cabaret singer was exposed to the secondhand smoke of clubs.) On the other hand, one of my editors used to describe his mother as smoking at 93.
I’ve known people who had cancer and just went about life as if everything were fine and people who were devastated by it. But here’s the thing: Your feelings about the disease, or any challenge, are just that — your feelings. You’re entitled to be private or open, as you wish, even in a public job once you inform those who must know.
What should we think of Lloyd Austin’s handling of his now public battle? We should have compassion for him, respect his choices, though we may disagree with some of them, and wish him well, knowing that in the words of Charles Dickens we are all “fellow passengers to the grave.”